Woman's warning after routine procedure results in lip removed, replaced with tongue

Pauline was left with a swollen mouth that felt like it'd been "punched" after getting lip filler — and a few weeks later, she was given her diagnosis.

Pauline Johnstone seen in before pictures.
Pauline Johnstone said that after she was injected with lip filler, her whole entire world was turned upside down. Source: Jam Press

A woman has detailed her harrowing ordeal after being diagnosed with cancer following a beauty treatment — revealing she had no choice but to reconstruct her lip using her tongue. As a beautician, Pauline Johnstone often tried out new treatments to offer her own clients. But after having a syringe of lip-plumping liquid injected, her life was on the line.

She was left with a swollen mouth that felt as if it had been "punched" — and a few weeks later, she noticed a cold sore lump on her bottom lip.

Johnstone, from Shrewsbury in England, was then diagnosed with squamous cell carcinoma — a form of skin cancer — and had to have her bottom lip removed and replaced with her tongue.

Pauline Johnstone's lip is seen here in hospital after having her lip reconstructed using her tongue.
After Johnstone's diagnosis, her tongue was used to reconstruct her lip. Source: Jam Press

"I couldn't bear looking in the mirror, as my mouth was essentially an open wound,” she told NeedToKnow. "I was told that I needed to remove my entire lip, as well as part of my chin, and if I didn’t, then the cancer would spread across my entire body.

"It was a huge decision to make — but I had no other option. The doctor couldn’t rule out [the cancer] was from the sun, but there was also a chance it was caused by lip filler. They found a gel at the bottom of the tumour, similar to dermal filler, where my surgeon said that was the most likely cause and that the procedure wasn’t safe — I was absolutely horrified."

Johnstone, 65, initially went to a dermatologist before the growth started to spread; eventually causing blood to ooze out onto her pillows. While shocked and disheartened about the cause — and her options for survival — she remained hopeful.

In January 2021, the tumour was removed, along with splitting her tongue in half, where one part was sewn over her bottom teeth down to the gums. The other half was attached to where her lip had been, and then a few weeks later, the stitches were removed.

Pauline Johnstone seen here in after photos.
After help from renowned medical tattooist Karen Betts, Johnstone's lip was eventually reconstructed to how it looks now. Source: Jam Press

Although delighted to be cancer-free, she felt self-conscious about her new mouth, which was discoloured and exposed her teeth. Johnstone then came across renowned medical tattooist Karen Betts, who has treated the likes of Katie Piper and Gail Porter.

The beautician went on a treatment journey to reconstruct her lips using a permanent makeup technique called lip blush in February 2023, which instilled her confidence to go out in public and enjoy life again. Johnstone is now sharing her story to raise awareness for skin cancer, as well as the dangers of getting lip filler.

She added: "I’m no longer covering my mouth for photos and I’m able to leave the house once again."Though it was never confirmed that my cancer was due to the lip-plumping treatment; I’d still advise against it.

"I never had the cold sore before getting injected and I should’ve known after the amount of pain I was in that something wasn’t right. I wouldn’t wish this upon my worst enemy. If I had a daughter, I would be refusing for her to go through a similar procedure.

"Don’t take the risk and ensure to wear suncream – it could be a matter of life or death."

Betts added: “I became a medical tattooist after a friend lost her eyebrow hair during chemotherapy. Getting them tattooed restored her confidence and I wanted to do the same for others. I’m glad I could help Pauline find her sparkle again."

- Jam Press

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